Treatment of hemorrhagic diathesis: what is important to consider

Hemorrhagic hemorrhages due to clotting defects or certain internal diseases require treatment as early as possible to maintain a favorable prognosis. The treatment of hemorrhagic diathesis is selected specifically for each patient, since the possible appointments strongly depend on whether this disease is congenital or developed as a secondary phenomenon after some kind of injury or thrombolytics, what complicating factors are accompanied, how massive the manifestations of bleeding are.

How to choose the right tactics for the treatment of hemorrhagic diathesis

The choice of treatment regimen for hemorrhagic diathesis depends on the origin of the disease, on how often it recurs and how long the next exacerbation lasts, how intense the bleeding is, where the hemorrhages are localized, whether iron deficiency anemia is present as a complicating factor, what complaints the patient makes .

Today, more than three hundred types of hemorrhagic diathesis are known, the level of bleeding varies from pinpoint rashes to massive hematomas and severe internal hemorrhages. Treatment of hemorrhagic diathesis depends on which group this type of hemorrhage can be assigned to – to thrombocytopathies, to coagulopathy or vasopathy. Some of them are associated with problems of platelet hemostasis, others – with defects in the vascular walls, the third – with disorders of certain phases of blood coagulation, with impaired coagulation or fibrinolysis.

Causes of hemorrhages and their relationship to the choice of treatment for hemorrhagic diathesis

Among the reasons why hemorrhagic diathesis develops or activates, the following are usually distinguished:

• congenital: manifest in early childhood, due to a hereditary defect in blood coagulation factors;
• acquired: increased bleeding in some internal diseases (cirrhosis, endocarditis, some types of fevers);
• Medications: in case of inadequate anticoagulant therapy.

Hemorrhagic diathesis treatment and prognosis

The approach to each patient when choosing the tactics of treating hemorrhagic diathesis should be individual, since in each case the cause of development and the form of the disease may differ. Glucocorticoids are usually used, if necessary, cytostatics. Plasmapheresis is possible, and in the most severe cases, splenectomy is indicated.

In hereditary forms of hemorrhagic diathesis, replacement therapy for a deficient clotting factor is prescribed.  Hemorrhages caused by an overdose of anticoagulants require correction of their dose or cancellation, as well as the appointment of vitamin K preparations. In DIC, it is also necessary to first eliminate the cause that caused intravascular coagulation, and then carry out hemocomponent replacement therapy.

Among the complications that can develop with hemorrhagic diathesis, it is worth remembering iron deficiency anemia, joint stiffness due to recurrent hemorrhages in them. Caution should be exercised in repeat blood transfusions, as this procedure always carries the risk of additional infection with hepatitis or HIV.

Fear should be massive internal bleeding that can compress the nerve trunks, and & nbsp; also cerebral and renal hemorrhages, in which the prognosis of the disease becomes unfavorable, with uncontrolled bleeding in malignant forms of the disease – fatal.

Thus, hemorrhagic diathesis in each case has its own characteristics, differs in course, form and possible outcome. With an early start in the treatment of hemorrhagic diathesis and an adequate chosen therapy, the prognosis of the disease is quite favorable.